Esophageal Cancer Linked to Heartburn

Esophageal cancer is the eighth most common type of cancer and
causes 12,000 deaths per year in the U.S. (2% of all cancer
deaths). One type of esophageal cancer, adenocarcinoma, accounts
for 50% of esophageal cancers and occurs primarily in Caucasian men.
The incidence of adenocarcinoma and deaths from esophageal cancer
have been increasing steadily in the U.S. and western Europe.

Gastroesophageal reflux disease (GERD), in
which acid refluxes from the stomach into the esophagus (known primarily for causing
heartburn) is a condition that afflicts 20% of the populations of the
U.S. and western Europe.

It has been
hypothesized that GERD is an important cause of adenocarcinoma of the esophagus.
Specifically, the hypothesis is that chronic reflux of acid
into the esophagus causes changes in the cells lining the lower esophagus--changes
that are referred to as Barrett's
esophagus--that ultimately lead the
cells to become cancerous. It is estimated that ½ to
1% of patients with Barrett's esophagus develop adenocarcinoma each year they
are followed. (This means that during 20 years a patient
with Barrett's esophagus has a 10 to 20% risk of developing adenocarcinoma.) Therefore, it
has been recommended that patients with Barrett's esophagus
undergo regular and frequent endoscopy (every year)
and biopsy of the esophagus so that early malignant changes can
be detected and treated early before cancer spreads.